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Click ‘Get Form’ to open it in the editor.
Begin by entering the applicant's name and DBA in Section I. Ensure that all contact information, including email and web address, is accurate.
Indicate the location address and check if it matches the mailing address. Fill in the city, state, and zip code.
Provide details about your professional services, including the type of professional you are (e.g., massage therapist) and the number of employees or independent contractors.
Answer questions regarding coverage for independent contractors, ensuring to verify their insurance status as required.
Complete any additional sections related to general liability or property coverage if applicable. Be thorough in detailing any claims history or relevant operational information.
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This includes all Nursing/Allied Health students requiring insurance for their clinical site rotations. All students are covered by a mandatory group accident
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